Background:
The Baltimore City Health Department implemented increased community outreach and screening in response to continuing high rates of primary and secondary syphilis in the city. A need was quickly identified to provide training to existing outreach staff - funded CBOs, new health department outreach staff and volunteers- in syphilis specific outreach techniques and general STD knowledge to complement their existing HIV outreach skills

Objective:
1, Assure all staff had a thorough knowledge of syphilis and motivational techniques to encourage clients to accept screening. 2. Assure all staff had the ability to safely and efficiently perform outreach in multicultural settings.


Method:
A training presentation was developed in three components: 1) STD and syphilis knowledge, 2) Outreach techniques, 3) Forms training. The components allowed different emphases to be used depending on the composition of the trainees. The time frame of the training could also be modified depending on the class needs.

Result:
Eight training sessions were conducted between August 2004 and November 2005, training 152 outreach workers including city employees, student volunteers and CBO outreach workers. Over 9000 clients have received syphilis testing through outreach since the training began. Actual data on screening prior to the training was not uniformly collected but this represents an increase of at least 7000 clients.

Conclusion:
: Providing syphilis specific training to outreach workers who typically focus on HIV outreach can have a major impact on increased syphilis screening and the identification of syphilis infected individuals.

Implications:
: In areas of high syphilis morbidity it is advantageous that staff understand the importance of obtaining a serologic syphilis test regardless of the method used for HIV testing and staff are more effective in doing so when they are trained in syphilis outreach techniques.